Final diagnosis

When Dr Ramesh Chandna entered the field, it was not as developed and diversified as it is now. “As a medical student I got my hands on Arthur Hailey’s The Final Diagnosis and was fascinated by the account of pathology and what it could be. It taught me what difference pathology can make in the treatment of various ailments. Even before studying for MBBS, I got an insight into pathology and chose the subject by the time I was doing postgraduation in 1972,” he says.

Many people opt for the clinical side where they have to deal directly with patients. In the non-clinical side, “all the reports or diagnostic services to the clinician come from the pathologist. Without their diagnosis, correct treatment will not be possible,” says Dr Chandna, Director, quality and laboratory services and blood bank, Asian Institute of Medical Sciences, Faridabad.

Dr Om P Manchanda, CEO, Dr Lal Path Labs, New Delhi, says, “Pathology is one of the most critical areas of medical science since 70 per cent of treatment decisions are based on lab tests. This statistic alone proves the importance of a pathologist in a patient’s life.”

There are two main branches of pathology in medical science — anatomical pathology and clinical pathology, and smaller branches such as forensic pathology, veterinary pathology, plant pathology, molecular pathology, surgical pathology, hematopathology, etc. Those wanting to work in this field can become specialists in one of the aforementioned branches. “But they have to remember that a lot of hard work goes in perfecting the skills in a laboratory. Pathologists also need to regularly upgrade their learning to keep abreast of the developments in the field of medicine,” says Dr Manchanda.

A lot has changed over the years in the profession and in the field. “When I was a student pathology was considered not so great. We did not have tools, radiology was not advanced. Gradually, things have changed and conclusive diagnosis is reached on the basis of a pathologist’s report. A patient wants to know what is happening to him/her, and a pathologist’s report has all the answers. When I was doing my course, the pathologists came to know of a patient’s condition when it was too late – after the autopsy was done. But now things have changed, clinicians send samples and we are supposed to make a diagnosis and give it to them quickly,” says Dr Chandna.

Pathology combines the art of medicine and the science of tissue morphology. Each case presents a challenge to the pathologist, who has to don the hats of both a physician and a scientist. “The thrill of observing DNA precipitate and the challenge of providing remarkably accurate data to clinicians and patients day after day is part and parcel of a pathologist’s professional life. This challenge is best met by devoting many hours of effort in obtaining the necessary knowledge and technical skills for a pathologist,” says Dr Manchanda.

The second major challenge pertains to the overall healthcare industry. The sector is undergoing one of the most massive transformations ever seen in any industry and will entail an escalation of challenges in the next few decades.

“Among these challenges are the proliferation of new technology and clinical information management systems, especially the utilisation of shared electronic health records. Pathology service in combination with sophisticated pathology informatics systems, is one of the major forces driving changes within the medical world through the adaptation of new technology. This factor, in the time to come, will be a major challenge in a pathologist’s professional life,” he says.

For aspiring pathologists, Dr Chandna has good advice. “You must spend the initial years in a good hospital, which has a good faculty. You will then get to deal with numerous samples every day and thus increase your learning experience. So when you come out of the hospital after three-five years you will not only be confident but also full of practical knowledge. Learning and improving is a continuous process.”


Author: HT Horizon

Date: 29th April, 2010

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